Reflux Can Precipitate Chest Pain, Cough

THURSDAY, Oct. 18 (HealthDay News) -- Severe chest pain and chronic cough are little known, but potentially serious, symptoms of gastroesophageal reflux disease (GERD), researchers say.

Many people with these symptoms don't realize they have GERD, the researchers noted in two studies presented this week at the annual scientific meeting of the American College of Gastroenterology, in Philadelphia.

In one study, a team at Brigham and Women's Hospital in Boston measured pH levels in the esophagus of 31 emergency department patients who complained of serious chest pain. Abnormal reflux of acid into the esophagus that would fit the diagnosis of GERD was found in 57 percent of the patients.

More women than men had chest pain that wasn't related to the heart. Men more often had upright reflux (which occurs when a patient is awake), while women experienced both supine reflux (occurs during sleep) and upright reflux.

"Often the role of acid reflux has been overlooked as a potential factor in the diagnosis and treatment of patients with serious chest pain. But, it is important for patients never to assume their chest pain is caused by GERD, until they have been thoroughly evaluated by a physician to rule out heart disease. If they experience persistent chest pain, they should seek emergency medical care," study lead investigator Dr. Julia J. Liu said in a prepared statement.

The second study, by researchers at the Medical University of South Carolina in Charleston, included patients with persistent cough who took stomach acid-suppressing proton pump inhibitor drugs over a period of three years. The study was conducted to assess the cost-effectiveness of a device (MII-pH) that can detect non-acid reflux. Conventional pH testing only measures acidity.

"The use of MII-pH testing in patients who experience reflux of non-acid stomach contents is cost-effective by helping clinicians determine which patients would benefit from anti-reflux surgery and excluding those for whom surgery may have no benefit. This warrants further evaluation of widespread application of MII-pH testing in the diagnosis of patients with persistent chronic cough on adequate medical therapy," researcher Dr. Deepika Koya said in a prepared statement.

-- Robert Preidt

SOURCE: American College of Gastroenterology, news release, Oct. 15, 2007

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